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The Preschooler

By Kimberly Sinclair RN CPNP

Oh my goodness! Speed and the ability to overcome only moves on. This is the stage of magical thinking (fantasy), imagination and ghosts and goblins! No other time of childhood can there be a period of imagination and innocent thought. Left on their own, they are so precious. Having an absence from neglect, abuse and lack of care, the possibilities are endless.


Children at this point will continue to grow at a rate of 5-6 pounds per year and 4-5 inches per year. Body parts continue to grow, as do coordination, the ability to see things around them and intelligence. Internal organs are approaching more adult abilities/levels. The brain continues to grow and function at a increased level.


The preschooler is balancing between imagination, learning new words, and increased complex thoughts. This includes things that do not directly affect them. Meaning thoughts are increasing as they are learning. Also, trying to communicate needs in a more adult manner. This is not easy! Initiative or the ability to seek what needs to be done, is the goal of this stage. Taking the lead to create/take opportunities to learn and grow.


Vision and hearing are basically at normal, adult levels. Any differences or problems need to be strictly addressed with your primary care provider.


The diet and nutrition of a preschooler is approaching the adult level. Except in amount. The average stomach size is the size of a preschooler’s fist. Unfortunately, many people feed their children much too much. Diet size is not adult size. Mostly because the stomach is the size of a 4-year-olds fist. And diet of about 4 small meals instead of 3 large ones might be helpful. Do not be confused, the average diet that is fed to children is insufficient. Fruits, vegetables and meats need to be included, not just hamburgers and French fries. The smaller amounts need to be packed with good, healthy food.

Other Developmental Needs:

If toilet training has started, it may be done or completing. Continue the consistency and doing the same thing daily. Also, it may be helpful to put the child into normal underwear. Training pants may keep them too dry and not encourage them to not be “wet”.

Discipline, if not started already, should be a chair against a wall or in the corner. One minute per year of age. If it is interrupted, it starts over. They will not like it or comply easily but they need to learn boundaries and rules. This doesn’t come easily for children, just through the independence stage. Look for industry or the ability to “me do”! A sticker chart, rewarding good behavior or skills may be helpful. Getting “rewards” for the sticker amount you choose. Smaller “prizes” for 10 stickers and larger ones for 25. Can they save enough stickers to hit 25?

Parenting is difficult at this stage. Wanting to balance the need to give and the need to parent is hard. Brothers and sisters may have arrived and being in different stages needs balance. Keep in mind, YOU are the parent, and not their friend. As challenging as the preschool years are, they are huge. Remember, if you get discouraged, you CAN do this! All of us, getting to be parents, went through these stages. If you had a difficult childhood... IT DOESN'T HAVE TO BE THE SAME. Parents are setting the groundwork for the important years to come and for what’s coming… SCHOOL!

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